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HusbandHIV+ and WifeHIV- II
Aug 28, 2002

Dear Dr. Benjamim, my husband wrote for you on Aug 24,2002. Thank you for your kind answer, God bless you and your medicine passion. At this moment, we are waiting his virus load result and we are trying to find a doctor with a significant HIV experience to begin his antiretroviral therapy, thank you very much for your advices!!! About my husband, I have good news!! All the complementary tests are negative (Hepatitis B, C and CMV).

This time I would like your comments about my situation. My Elisa test was done in June 15,2002. The result was negative. In our vacation on July , we try unsuccesfully have a baby. On August , we found out my husband is HIV+. We avoid sexual contact since August. Please, tell me what I can do for me now . His low CD 4 count would suggest infection that occurred at least three (maybe several more) years ago. Until June 15,2002 I am sure I was not infected. It is really a very long time (three years or more)expose to his semem HIV infected. Is it possible to be imune to HIV? If not, there is a chance to be infected after my negative test in June 15,2002. How long time I need to wait to make another antibody test? How many tests will be trustfull? OK, if the HIV infection is possible, do you recommend starting any kind of therapies in the early stage without confirmation of Elisa's test results? I have 37 years old. One more question, if I am imune for HIV , probably there are other persons in the world too. Is it possible to give part of my blood for my husband as a therapy? Is it possible to tranfer a unknown thing during transfusion? We have the same type :) Thank you Doctor Benjamim.

Response from Dr. Young

Thanks for your kind comments.

Saddly, I can't counsel you that you're immune to HIV, but only to say that you're very lucky-- the actual rate of infection per intercourse event is surprisingly low (depends a lot on how you have sex, what his viral load is). You are correct that his low CD4 count implies infection some time ago, and therefore, that you've likely been exposed many times.

As for what to do now, I'd certainly advise using condoms whenever possible (really all the time). This doesn't address the issue of pregnancy, of course. This issue becomes quite complicated for a number of reasons; one option is in vitro fertilization with donated sperm (the safest), another option explored in a few clinics around the world is "washing" of sperm from the HIV-infected male partner. I'm personally not aware of who is performing this in the US, nor of it's safety record, but I am told that it can be done.

Another option that some couples have done (perhaps against medical advice) is to wait until the viral load (of the man) is undetectable, then have unprotected intercourse. I'd have to say that this option makes me nervous for your health, and would not advise, but you should be aware that some do this approach.

Regarding your testing, I'd repeat a HIV antibody test in 3 and 6 months to be sure that you've not acquired HIV recently. Clearly the negative test earlier is very reassuring.

Good luck. Thanks for keeping us informed. -BY


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